Tuberculous otitis media (TOM) is a rare cause of chronic suppurative infection of the middle ear. Clinical symptoms are nonspecific making delayed diagnosis. We present the case of an infant, aged 22 months, having immune deficiency, who was admitted for a left externalized otomastoiditis. The radiological assessment confirmed this diagnosis. The child had a surgical drainage of the collection with biopsy of granulation tissue whose histopathological examination found a caseo-follicular tuberculosis. Despite its rarity, TOM is associated with a high rate of complications. The diagnosis should be considered in any suppurative chronic otitis resistant to standard treatment.